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| The draft Human Transplantation Bill would create a "soft opt out" system, whereby anyone not specifically opting-out of a new organ donor register will have presumed to have "opted-in". (Pic : The Telegraph) |
Following on from my post last year on the Organ Donation white paper, Health Minister
Lesley Griffiths (Lab, Wrexham) has launched what is likely to be one
of the most controversial moves the Assembly has made since
devolution.
The Draft Human Transplantation Bill will introduce a soft opt-out system for organ donation in Wales. If the final bill is passed, it'll come into effect in 2015.
How will the proposed "opt-out" system work?
There'll be a separate organ donation register for Wales, and will list whether a person has opted to donate or not to donate.
Consent will still be asked from the close families (dubbed a "qualifying relationship") of the deceased before any donation, and they can still object. The difference is those who have neither opted-in or opted-out will be presumed to have opted-in.
The Welsh Government will be legally obliged to promote transplantation (as currently) and explain the opt-out system fully to the public.
In fact, in the Bill, it'll become a criminal offence - punishable by up to 3 years in prison - to transplant organs without consent, or use them for "a purpose that is not a qualifying purpose".
I presume "not qualifying purpose" would include anatomical dissection, display or other forms of retention.
Who would be subject to the law?
The Draft Human Transplantation Bill will introduce a soft opt-out system for organ donation in Wales. If the final bill is passed, it'll come into effect in 2015.
How will the proposed "opt-out" system work?
There'll be a separate organ donation register for Wales, and will list whether a person has opted to donate or not to donate.
Consent will still be asked from the close families (dubbed a "qualifying relationship") of the deceased before any donation, and they can still object. The difference is those who have neither opted-in or opted-out will be presumed to have opted-in.
The Welsh Government will be legally obliged to promote transplantation (as currently) and explain the opt-out system fully to the public.
In fact, in the Bill, it'll become a criminal offence - punishable by up to 3 years in prison - to transplant organs without consent, or use them for "a purpose that is not a qualifying purpose".
I presume "not qualifying purpose" would include anatomical dissection, display or other forms of retention.
Who would be subject to the law?
- People over the age of 18
- Who have "capacity" to understand the procedure (it exempts those with learning disabilities for example)
- Who have lived in Wales for more than 6 months and die in Wales
For those under the age of 18, eligible to be a donor, their own wishes will be the only consideration. They'll be contacted by the Welsh NHS in the months leading to their 18th birthday to tell them of the new arrangements.
What are the potential benefits and drawbacks?
The explanatory memorandum lists that the new system will cost around £5million to set up, payable by the Welsh Government.
However, it also estimates that a single extra donor a year has a "net present value" of £5million (what I presume includes increases in quality of life, savings in dialysis treatment for kidney patients etc.). If the stated aim of 15 extra donors a year is met, then it's listed it could be worth £150million. An extra 25 donors would be worth £254million. There's a more detailed analysis in the memorandum if you are interested.
What's likely to be the most contentious issue surrounds whether organ donation is an altruistic "gift", rather than something the state presumes you want to do upon death because it's a "good thing". If there's no increase in organ donation, or if "compulsion" encourages people to opt-out, then it could prove self-defeating, and harm Wales' pretty decent record in organ donation.
That issue....
Yes, in the draft bill, any donated organ in Wales will be available to anyone in the UK as existing. The relevant part of the draft bill is section 15 (1)(b) which amends the Human Tissues Act 2004.
You can certainly argue that - as Wales could be about to put several hundred thousand extra potential donors on the register - England, Scotland and Northern Ireland have moral obligation to follow suit to benefit from any extra "Welsh" organs.
But....
As I said in my previous post, you shouldn't try to limit the "pool" for potential organ donors. I argued that ideally there would be a pan-EU or pan-European organ donor scheme. Just because somebody is Welsh, it doesn't mean they'll always be able to find a compatible donor within Wales. Organs move both ways across borders, and if you're in the situation of needing one, I don't think you'll care where it comes from – you'll just be thankful you have a chance of a semblance of a normal life.
There'll be plenty of non-Welsh incomers who'll be subject to this law.
Organ transplantation should always be judged on the basis of need. If there's a more needy Welsh person, they should get it - just as if there were a more needy Scot , Irish, German, Pole or even - God forbid - English.
